TY - JOUR AU - Shim, Hunbo AU - Jeon, Chang Seok AU - Park, Pyo Won AU - Kim, Wook Sung AU - Lee, Young Tak AU - Jeong, Dong Seop AU - Cho, Yang-hyun AU - Sung, Kiick PY - 2018/06/18 Y2 - 2024/03/29 TI - Perioperative Outcomes of Repeated Open Surgery on the Thoracic Aorta JF - The Heart Surgery Forum JA - HSF VL - 21 IS - 4 SE - DO - 10.1532/hsf.2004 UR - https://journal.hsforum.com/index.php/HSF/article/view/2004 SP - E263-E268 AB - <p class="p1"><span class="s1"><strong>ackground: </strong>Repeated thoracic aorta repair is increasingly common. With the increase in hybrid procedures, determination of the best treatment strategy requires evaluation of the clinical outcomes of classic open surgery.<span class="Apple-converted-space"> </span></span></p><p class="p1"><span class="s1"><strong>Methods:</strong> We retrospectively reviewed 119 patients <br /> (84 men and 35 women, aged 51.0 ± 16.7 years) with a history of open repair involving the thoracic aorta above the diaphragm. The patients underwent an average of 1.3 ± 0.8 surgeries (range: 1-8) on the thoracic aorta before the final operation. Clinical outcomes were evaluated on the basis of the need for emergency surgery, indications for surgery, pathologic causes, and other operative variables.</span></p><p class="p1"><strong>Results: </strong>Hospital mortality was 6.7% (n = 8). Postoperative bleeding occurred in 16% (n = 19). On multivariable analysis, emergency surgery (odds ratio [OR], 19.005; <em>P</em> = .003; 95% confidence interval [CI], 2.710-133.305) and cardiopulmonary bypass (CPB) time (OR, 1.562 per 30 minutes; <em>P</em> = .007; <br /> 95% CI, 1.126-2.165) were predictors of hospital death. Emergency surgery (OR, 4.105; <em>P</em> = .029; 95% CI, 1.157-14.567) and CPB time (OR, 1.189 per 30 minutes; <em>P</em> = .035; 95% CI, 1.012-1.396) were also associated with postoperative bleeding, in addition to surgery for an infectious cause (OR, 10.824; <em>P</em> = .010; 95% CI, 1.755-66.770). Estimated survival at 1, 5, and 7 years was 86.6%, 80.5%, and 78.2%, respectively.<span class="Apple-converted-space"> </span></p><p class="p1"><span class="s1"><strong>Conclusion:</strong> Despite the variety of preoperative conditions and operations performed, repeated open surgery for thoracic aorta repair can be performed with acceptable early and late outcomes.</span></p> ER -